Eligibility & Sponsorship Team Lead

HealthFund Solutions LLC; Daytona Beach (FL); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Life Insurance

Disability Insurance (Short/Long Term)

Critical Illness & Accident Plans

401(k) with up to 4% employer match

Job summary

HealthFund Solutions LLC is seeking an Eligibility/Sponsorship Team Lead to support the Eligibility Manager in coordinating daily operations at a hospital in Daytona Beach, FL. The role oversees caseworkers, liaises with hospital and HealthFund Solutions management, and ensures timely processing of applications.

Responsibilities include supervising the eligibility team, maintaining logs, handling sponsorship delinquencies, and supporting open enrollment periods.

Qualifications

• Must be able to lead by example and guide staff
• Strong organizational and time-management skills
• Ability to protect PHI and adhere to HIPAA guidelines
• Excellent verbal and written communication with hospital staff

Responsibilities

• Distribute daily census and oversee eligibility staff
• Review applications for submission to case resolution specialists
• Monitor sponsorship delinquencies and coordinate income support
• Maintain meeting minutes and logs (HCRA, EQ Authorization)
• Assist onsite with screening or submitting applications as needed
• Support open enrollment activities and monthly closeouts

Skills

Leadership

Team leadership

Organizational skills

HIPAA compliance

Clear communication

Teamwork

Problem solving

Computer literacy

Education

High School Diploma

College degree preferred

Job description

Description

Reporting to the Eligibility Manager, the Eligibility/Sponsorship Team Lead will support the Manager in carrying out the objectives and goals of HealthFund Solutions (HFS) through daily operations. The Team Lead in the Eligibility Manager’s absence, will plan, direct, and coordinate the operations of the Eligibility staff including overseeing caseworkers, communicating with HealthFund Solutions management, and interacting with hospital staff and administration. This position is located onsite at a hospital facility in Daytona Beach, Fl. The schedule is Monday-Friday 8:00am-4:30pm.

Benefits:

• Medical, Dental, and Vision Insurance
• Life Insurance
• Short-Term and Long-Term Disability
• Critical Illness & Accident Plans
• 401(k) with up to 4% employer match

Responsibilities:

• Distribute daily census
• Review applications for submission to case resolution specialists
• Review sponsorship delinquencies for patient contact
• Approve sponsorship delinquencies for dedicated income support
• Maintain minutes for weekly team meetings
• Maintain HCRA application log
• Respond to and distribute direct referrals from Halifax email timely
• Review Medicaid approvals daily and add to EQ Authorization log
• Request supplies
• Assist onsite with screening or submitting applications as needed
• Review and shadowing of new hire post training
• Assist with Marketplace escalations
• Required assistance with management at end of month to ensure all applications are submitted
• Maintain CAC certification yearly
• Required overtime during Open Enrollment
• Stay up to date with changes to the ACA marketplace plans and policies, including attendance to webinars.
• Attend meetings on camera, unmuted and ready to participate.

In Manager’s Absence or as needed:

• Attend weekly in-house, LOS, and Tumor Board meetings
• Review of outstanding follow-ups and applications
• Review sponsorship requests for dedicated income support
• Mail out HCRA applications via certified mail
• Report callouts, timecard corrections, and tardiness to the Regional Operations Manager
• Assist with patient refusals as requested including communicating actions and updates to hospital leadership
• Employee may be asked to perform other duties as required to meet the ongoing needs of the organization

Requirements:

• High School Diploma required
• College Degree or some college preferred
• Three (3) years of related experience required
• Ability to lead by example
• Provide support, guidance, and direction to staff
• Possess organizational skills
• Ability to maintain and respect confidentiality, protect PHI, and adhere to HIPAA guidelines
• Ability to read, comprehend, and implement instructions and policies
• Ability to be self-directed and to work effectively as a member of a team
• Must be able to demonstrate flexibility, adjust quickly to shifting priorities and stay focused during stressful or difficult situations
• Computer skills required to perform job effectively
• Must be able to communicate, effectively, clearly and concisely in both verbal and written formats

Physical Abilities:

While performing the duties of this job

• Ability to walk for long periods of time
• Ability to sit for long periods of time entering data into the computer
• Ability to occasionally lift up to 10 pounds
• Ability to concentrate and stay on task for long periods of time

NOTE: This job description is not intended to be all-inclusive. Duties may be adjusted as needed to meet organizational needs.

All candidates must successfully pass a national background check and a 12-panel drug screening. HealthFund Solutions is a drug-free workplace.

We are an equal opportunity employer. All qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status